The Surgeon General's Report on Oral Health stressed the significance of understanding how to bring oral health care to those segments of the US population that need it most, but are underserved. Children from socio economically disadvantaged backgrounds are one of these groups. Gaining a clearer understanding of how to improve their situation is the overall objective of this proposal. The concrete aims are (a) to validate the self report version and the parent/guardian (proxy) version of the Michigan Oral Health-Related Quality of Life (MOHRQOL) Scale for children (Aim 1), (b) to design and validate a short screening version of this instrument that parents/guardians and teachers can use to identify children in need for oral health care (Aim 2), (c) to identify the factors that ultimately determine parents'/guardians' decisions to seek oral health care for a child (Aim 3), and (d) to develop and evaluate educational material for parents/guardians and teachers/school administrators to alert them to the importance of regular preventive oral health care for elementary school age children as well as how to obtain reparative care once a child in need is identified (Aim 4). In order to investigate these aims, a research project is proposed that collects data from elementary school children, their parents/guardians, and teachers. In Study 1, survey data will be collected (a) from elementary school age children from underprivileged backgrounds about their ohrqol (N=3,000), and (b) from their parents/guardians (N=400) about their child's oral health, oral health care needs, and oral health-related quality of life. The children's oral health will be determined in oral exams. This study is used to validate the MOHRQOL - child and parent (proxy) versions (Aim 1), and to do a test-item analysis to identify the items that can be used in a screening instrument for parents and teachers. In Study 2, teachers (N=300) will be surveyed to assess their awareness of how oral health problems might interfere with learning, and whether they can identify when this is the case. In Year 2, the screening versions of the MOHRQOL for parents / guardians and teachers will be validated (Aim 2) by conducting Study 3. This study collects oral health data from children (N=3,000), as well as data collected with the screening instrument from children, parents/guardians (N=400), and teachers (N=300). Study 4 is designed as a focus group study with parents/guardians and teachers. Its goal is to identify the factors that shape parents'/guardians' decisions to seek oral health care for a child (Aim 3), and determine which informational needs parents and teachers have concerning children's oral health. Based on these findings, educational material for parents/guardians and teachers will be developed and its effectiveness will be evaluated in Study 5, a survey study of parents' (N=400) and teachers' (N=300) evaluations of the educational materials (Aim 4). [unreadable] [unreadable]